Individual
MISS AMANDA M HETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
505 LAKE ST, GREEN LAKE, WI 54941-8820
(920) 294-3130
(920) 294-3238
Mailing address
PO BOX 458, GREEN LAKE, WI 54941-0458
(920) 294-3130
(920) 294-3238
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5477-12
WI
Other
Enumeration date
09/09/2019
Last updated
08/28/2022
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